Page 59 - Insurance Times December 2022

5. We are in receipt of the comments / suggestions from ceeds the projected expenses by more than 10 per-
the stakeholders on the proposed regulations even on cent.
date.
8. All the stakeholders are requested to forward their com-
6. In order to re-engage with the stakeholders and to con- ments / suggestions, if any, on the proposed regulations
solidate their comments on the revised proposed Regu- (Annexure-A) in the attached format (Annexure- B) on
or before 5:00 PM on 14th December, 2022 to finance-
lations, the exposure draft of revised IRDAI (Expenses of
Management of Insurers Transacting General or Health nonlife@irdai.gov.in.
Insurance Business) Regulations, 2022, is attached as
Annexure – A for their comments/suggestions. Ayushman Bharat Digital Mission (ABDM)
7. Some of the salient features of the draft Regulations are adoption by Doctors
as under: -
17th November, 2022
(i) The Regulations supersede the IRDAI (Expenses of
Management of Insurers transacting General or
1. The Insurance Regulatory and Development Authority
Health Insurance business) Regulations, 2016; of India (IRDAI) is in receipt of a communication from
(ii) Applicability of the Regulations w.e.f. 01.04.2023; National Health Authority (NHA) on the captioned sub-
ject. It is informed that as part of Ayushman Bharat
(iii) Insertion of single limit of Expenses of Management
Digital Mission, NHA has incorporated a Healthcare
as against existing segmental /sub-segmental limits;
Professional Registry (HPR), a comprehensive repository
(iv) Revision of limits on expenses to: - of registered and verified practitioners of healthcare
a. 30 percent in case General Insurers, professionals delivering modern as well as traditional
healthcare services across India.
b. 35 percent in case of Standalone Health Insur-
ers, of gross premium written in India in that 2. Under HPR, a Healthcare Professional ID (HPID) will be
financial year. created via Aadhaar or other KYC, along with the medi-
cal qualifications of the medical professional which is
(v) Insertion of additional allowances towards Rural
verified by their respective State Medical Councils. This
Sector & Govt. Welfare oriented schemes;
HPID serves as a unique ID to the medical practitioners
(vi) Insertion of additional allowances for expenses to- to enable connection with all stakeholders of
wards ‘Insurtech’ and ‘Insurance Awareness’; healthcare ecosystem. Therefore, in order to make the
best use of the registry all the General and Health In-
(vii) Manner of transfer of benefits, arising from reduc-
surers are advised that:
tion of expenses to the policyholders by way of re-
duction in the premium; a. The General Insurers are advised to consider cap-
turing / collecting HPR ID as a verification to vali-
(viii) Submission of Board approved business plan on the
date / authenticate the medical practitioners while
projected capital requirements, projected solvency
issuing / renewing policies for Medical Malpractice
requirements and projected expenses of manage-
under Professional Indemnity cover. This will enable
ment in terms of allowable limits;
the digitization and ease the process of buying and
(ix) Authority may grant forbearance to new insurers in
selling the Professional Indemnity policies and push
case of excess expenditure up to first 5 years of ‘du- for HPR registration among the healthcare profes-
ration of business’; sionals.
(x) Glide path of three years up to FY 2025-26 for insur- b. The General and Health Insurers offering health in-
ers which are not compliant with the expense limits surance policies can also consider leveraging on the
laid down in the Regulations; Health Professional Registry for building up the
network of doctors / physicians or other healthcare
(xi) No variable pay to Managing Director (MD) / Chief
professionals for providing OPD or other healthcare
Executive Officer (CEO) / Whole-Time Directors
services.
(WTD) and Key Management Persons (KMPs) for the
said financial year in which the actual expenses ex- This has the approval of the competent authority.

The Insurance Times December 2022 51